Veteran Perspectives on Adaptations to a VA Residential Rehabilitation Program for Substance Use Disorders During the Novel Coronavirus Pandemic

Abstract

Individuals attending residential rehabilitation programs for substance misuse are particularly vulnerable to treatment disruptions spurred by the novel coronavirus disease 2019 (COVID-19) pandemic. We describe adaptations to services within a large residential rehabilitation program for under-resourced veterans, report veterans' experiences with these changes, and outline successes and challenges encountered throughout adjustment to the pandemic. Data collected from two focus groups with nine veterans engaged in this program during the pandemic highlight experiences of inconsistent communication about residential policies, interruptions to medical and addiction services, and feelings of confinement and social isolation. Overall, these findings suggest the need for health systems to support clients in taking an active role in communications, provide additional technical and social support in transitioning to virtual health services, and offer alternative means for clients to maintain social connection during a pandemic. Understanding clients' perspectives can inform strategies to promote continuity of care and enhanced care experiences.

Staff and Veteran Perspectives on Residential Treatment Programs’ Responses to COVID-19: A Qualitative Study Guided by the WHO’s After Action Review Framework

“…Comparisons of our results with the two other aforementioned qualitative studies (Clair et al, 2021 ; Pagano et al, 2021 ) demonstrate the potential utility of the AAR to reveal a broad representation of experiences and recommendations from multiple perspectives – leadership, staff, and patients. The AAR format can facilitate findings to be considered for possible programmatic and care-delivery changes in public, not-for-profit, and private healthcare organizations.…”

“…Two qualitative studies (Clair et al, 2021 ; Pagano et al, 2021 ) and two commentaries (Fareed & Fareed, 2021 ; Herrera 2021 ) previously examined COVID-19 experience in residential treatment programs. One of the two qualitative studies ascertained COVID-19’s perceived impact through two focus groups with nine Veterans at a large VA homeless RRTP in southern California (Clair et al, 2021 ), identifying three challenges – communication, interruption of services, and social isolation/confinement. These areas were also raised in our small-group discussions.…”

Experiencing COVID-19 through the Eyes of Homeless Military Veterans: A Qualitative Study

“…Understanding clients' experiences with COVID-19 changes had illuminated specific strategies, such as telehealth, that can facilitate engagement and lessen psychological stress JHHSA Vol 45 Issue 3 for the homeless during this challenging and difficult time (Clair et al, 2021).…”

Coexisting Substance Use Disorder and Chronic Pain During COVID-19

“…In addition, effective treatment for SUDs often includes comprehensive services, including housing and social services; however, due to the pandemic and financial concerns, many treatment centers have had to close or scale back their services (Alexander et al, 2020). Data collected from focus groups of veterans in a residential treatment program that instituted COVID-19 related restrictions highlighted concerns associated with inconsistent communication about residential policies, interruptions to medical and addiction services, and feelings of confinement and social isolation (Clair et al, 2021). Attempts to deliver safe care with respect to the virus has undoubtedly led to disruptions of and less effective treatment services.…”